Brief Screens: Many people experience mental health and substance use problems without seeking professional help. Brief screens can help people decide whether to seek formal evaluation of their mental health or substance use problems, which often translates into earlier care and better treatment outcomes. Brief screens also can help healthcare providers identify patients or clients who need further evaluation. As a service to our readers, we present some brief screens for addiction and conditions that often co-occur with addiction. If you are at all concerned about your responses to any of these screens, we urge you to share these concerns with a healthcare professional. To find a behavioral health professional near you in the United States, click here.
- Gambling: We are pleased to announce that you can find one recent screen, the Brief Biosocial Gambling Screen (BBGS) here. The 3-item BBGS is based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for pathological gambling. Click here to use the BBGS Gambling e-Screener and Intervention System.
- Drinking: The CAGE: The CAGE is a 4-question screener designed for healthcare providers to ask their patients. It is a mnemonic device to remind treatment providers to ask if patients these questions:
- Have you ever felt you should Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt bad or Guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye-opener)?
Someone who answers “Yes” to at least two questions is considered to have a positive result and should be evaluated further. For more information, click here to visit the National Institute on Alcohol Abuse and Alcoholism website on screening for alcohol problems.
- Substance use: The CRAFFT: The CRAFFT is a brief substance use screening tool for healthcare providers to ask their adolescent patients.
- C -Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs?
- R - Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?
- A - Do you ever use alcohol/drugs while you are by yourself, ALONE?
- F - Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
- F - Do you ever FORGET things you did while using alcohol or drugs?
- T - Have you gotten into TROUBLE while you were using alcohol or drugs?
Two or more "yes" answers suggest a significant problem. For more information about The CRAFFT, click here to visit The Center for Adolescent Substance Abuse Research website, created by Children's Hospital Boston.
- Substance use: The DAST-10: The DAST-10 is a 10-item, yes/no self-report questionnaire that takes less than 10 minutes to complete. It was designed as a tool for providers to identify which patients need extra evaluation and, potentially, treatment for problematic substance use. It was designed for use with adults and older youth. For more information, click here to visit the Substance Abuse and Mental Health Services Administration (SAMHSA) page on screening tools and scroll down to the DAST-10.
- Mental health: Depression and Anxiety. Depression and anxiety often co-occur with expressions of addition. If you suspect you are experiencing depression or anxiety, consider these questions and discuss your responses with your health care provider:
Over the past 2 weeks, have you been bothered by any of the following problems?
- Having little interest or pleasure in doing things;
- Feeling down, depressed, or hopeless
- Feeling much more anxious or worried than most people
- Feeling so nervous that nothing could calm you down
Self-help tools: Many people change their excessive behavior patterns without entering treatment. The Division on Addiction has created a series of self-change toolkits. These toolkits are designed to do three things:
- They will help people gain information about addiction-related problems.
- They will help people evaluate their own addiction-related behavior.
- They will help people develop change strategies, should they decide that change is the best course.
It takes about 20 minutes to complete one of these toolkits. Participation is anonymous and identifying information from participating visitors is not collected or stored. The toolkits will keep track of your answers and allow you to print your results at any point during an individual session. However, if you close or refresh your browser during a session, your answers will be erased. We will not keep records of your answers, and your identity will remain anonymous at all times. We hope that this first step will help you find the change that you are looking for.
- New! Your First Step to Change: 2nd Edition The Division recently published the second print edition of Your First Step to Change. Go to Your First Step to Change: 2nd Edition.
- e-Your First Step to Change The following electronic editions of Your First Step to Change are based on the 1st Edition:
- Your First Step To Change: Gambling
- Your First Step To Change: Drinking
- Your First Step to Change: Smoking
- Your First Step to Change: Marijuana
- Your First Step to Change:Shopping
- Download Your First Step to Change, 1st Edition The first edition of Your First Step to Change is freely available to download in English, as well as several other languages:
- Addiction Medicine is a live CME course held annually in the fall on the campus of the Harvard Medical School. This course provides useful information about practical methods of diagnosis, intervention and management of patients with substance abuse problems. .
- Addiction in Your Practice: Information and Resources for Dealing with Addictive Behavior is a Harvard Medical School administered on-line Continuing Medical Education (CME) course. Psychiatric comorbidity, such as addictive behavior, is common in a variety of treatment settings and has far-reaching consequences. Complications from addictive behavior can impede treatment progress, lead to additional problems, and increase the chance of treatment failure. Consequently, there recently has been increased demand on medical care workers who do not specialize in addiction (e.g., nurse practitioners, general practitioners, obstetricians, trauma specialists, etc.) to assess, intervene, and provide referrals for their patients who demonstrate addictive behavior. However, research suggests that many medical care providers lack addiction-related training and resources. The goals of this online course are to improve participants’ understanding of addiction and its influence on medical care. We will discuss the theoretical and clinical aspects of addictive behavior, as well as strategies for dealing with patients who demonstrate addictive behavior.
- Gambling Disorder in Your Practice: Information and Resources is a Harvard Medical School administered online CME course. This course is dedicated to increasing providers’ understanding of gambling disorder and its importance to their practice. This course includes information about the epidemiology and clinical features of gambling disorder and will detail options for primary care providers with regard to the screening and referral of gambling disorder. The course will include address specific learning objectives related to the screening and treatment of gambling disorder and will take a case-based approach, including multiple choice questions, high-quality images, interactive modules, an individualized study guide, and a list of references. To learn more about the course, or to register, please click here.
- Research Methods 101 for the Provider: A Guide to Critical Research Consumption is a Harvard Medical School administered online CME course dedicated to increasing providers' understanding of research methods in clinical settings. The primary goal of this course is to provide participants with the tools necessary to be critical consumers of research and (if desired) begin to design their own research. By the end of the course, participants will be able to critically evaluate empirical research, identify critical components and potential pitfalls of research designs, and determine the appropriate research design for a given research question. The course takes a case-based approach, including multiple choice questions, high-quality images, interactive modules, an individualized study guide, and a list of references. To register, please click here.
Expressions of Addiction
Expressions of Addiction is an exhibit of original photographic portraits that depict people during various stages and expressions of addiction. Each portrait includes a biographical information about each subject derived from in person interviews. These photographs are part of an exhibition that will help the public better understand addiction by reaching hundreds of thousands through gallery exhibitions, television programming, and Internet web sites. Click here for more information.
The Division on Addiction's Reprint Library
The Division on Addiction provides access to article reprints, lecture handouts, and other Division on Addiction publications. These publications are free, and most are available for download to the general public. Click here to visit the Division on Addiction Library and Archives.